What China’s devastating Covid outbreak means for the rest of the world

Every year, China’s leader Xi Jinping delivers a televised New Year’s Eve address to the nation that celebrates the accomplishments of the previous 12 months and the country’s supposedly bright future under the leadership of the Chinese Community Party (CCP). But at the end of 2022, among the usual blandishments, he also offered a rare acknowledgment of the myriad difficulties that China is enduring.

“With extraordinary efforts, we have prevailed over unprecedented difficulties and challenges, and it has not been an easy journey for anyone. We have now entered a new phase of [the] Covid response where tough challenges remain,” Xi said, sitting behind a large desk in a wood-panelled office in Beijing. “Everyone is holding on with great fortitude, and the light of hope is right in front of us. Let’s make an extra effort to pull through, as perseverance and solidarity mean victory.”

For much of the previous three years, Xi had insisted that “victory” meant continuing with China’s “zero Covid” strategy, which aimed to keep cases as close to zero as possible through a system of mass testing, strict lockdowns and extensive contact tracing.

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He had held up the country’s handling of the pandemic as proof of the superiority of the Chinese political system, in contrast to the purported chaos and dysfunction of Western democracies, where hospitals in the US and Europe had been rapidly overwhelmed by the spread of the virus in 2020. But with the arrival in China of the highly transmissible Omicron variant in December 2021, the economic and social costs of the policy had spiralled, with millions of people confined to their homes as they endured successive lockdowns. By the end of 2022, following a remarkable wave of street protests against the pandemic controls, the authorities abruptly reversed course.

On 7 December, the government announced new rules that effectively signalled the end of the zero-Covid policy. People cheered as the ubiquitous testing booths that had lined city streets were hoisted on to trucks and driven away, and quarantine restrictions were relaxed. “We’re going to be free,” read a typical message on the Weibo social media platform after the changes were announced. Another said, “Daylight is here.”

The euphoria, however, was short-lived. Within 24 hours there were reports of long queues forming outside testing centres and designated fever clinics in Beijing, and it emerged that many people faced shortages of basic medical supplies, such as ibuprofen, as residents attempted to stock up. The Chinese government had failed to use the previous three years to prepare for this moment – by boosting vaccination levels among the elderly, stockpiling antiviral treatments and investing in critical care capacity – but it decided to open up regardless of its readiness to do so.

“Since Covid-19 struck, we have put the people first and put life first all along,” Xi insisted in his New Year’s Eve speech. Yet this is not true. Had he genuinely sought to put lives first – above, say, national pride and the CCP’s obsession with control – he could have approved the more effective foreign mRNA vaccines for use in China. He has not. (The Pfizer-BioNTech vaccine was approved for some foreign nationals in December, but has yet to be sanctioned for widespread use.)

Xi could have also led a nationwide campaign to win over vaccine sceptics, particularly among the older population (one third of people in China over 80 are not fully vaccinated), and emphasise the importance of receiving booster shots – three doses of the Chinese-made vaccines are needed to protect against serious illness. Perhaps he could have set an example by receiving his own vaccine on camera. He did not.

Instead, Xi has plunged the country into a crisis that is worse than it needs to be. Vulnerable people who could have been better-protected will die; although ascertaining exactly how many will be difficult as health authorities have set strict conditions for Covid-19 to be recorded as an official cause of death, presumably to mask the true scale of the outbreak. According to the story the official figures tell, just 12 people died from the virus in China in December, with around 5,000 new infections being recorded every day. If the circumstances were not so tragic and the stakes not so high, the sheer absurdity of the government’s statistics would be laughable.

The true toll is likely to be many magnitudes higher, with around 9,000 people dying from Covid every day, according to Airfinity, a UK-based health data firm, which estimates that China could suffer 1.7 million deaths by the end of April. This would mean more people dying in China from the virus over the next four months than in the last three years in the United States. Other estimates range from around 1 million to 2.1 million deaths over the next year, based on low levels of natural immunity among the population, an already stretched and underfunded healthcare system that could be quickly overwhelmed, and insufficient levels of vaccination among the older population. Added to this, the decision to abandon pandemic controls in the depths of winter, when people tend to socialise indoors and the flu season is under way, will compound the pressure on China’s hospitals and emergency services.

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The World Health Organisation (WHO) has already warned that intensive care units in China are filling up and has urged officials to share more information about the outbreak. Tedros Adhanom Ghebreyesus, the director-general of the WHO, has said he is “very concerned over the evolving situation in China”. The consequences will be felt beyond its borders. Numerous countries, including the US and UK, have introduced new Covid testing rules for passengers arriving from China as fears grow of a renewed surge in infections elsewhere.

In late December, 50 per cent of passengers on two flights from China tested positive for the virus upon arrival in Milan, according to the Italian health authorities. Concerns that a new variant might emerge have also intensified (although there is no evidence of this so far). China’s economy, long a critical engine of growth around the world, has also been hit, with activity in the manufacturing and service sectors slowing in December to their lowest levels since the start of the pandemic, and some factories forced to suspend production due to shortages of workers, threatening to further disrupt global supply chains. The International Monetary Fund predicted on 1 January that for the first time in 40 years, China’s growth could dip below overall global levels, contributing to a difficult 2023 that will be “tougher than the year we leave behind”.

The worst is likely still to come, with the Lunar New Year holiday – which generally entails extensive travel across the country and has been described as the world’s largest annual human migration – due to begin on 22 January. This means that millions of workers in the major cities, where infections are surging, are about to return en masse to the rural towns and villages that are least equipped to cope with an outbreak. Xi Jinping ended his speech with a call to “welcome the first ray of sunshine of 2023 with the best wishes for a brighter future”, but there are difficult days in China ahead.

[See also: How Xi Jinping views the world]